Speech Therapy and Language Therapy is Liberated - When we think for ourselves we understand what we do.

Sunday, 22 February 2015

Aphasia Therapy Works

I have worked with people who
have dysphasia for years and in the early 90’s I was a Tutor at the City
University’s Dysphasic Group set up by Bob and Maggie Fawcus. An amazing therapeutic
and research facility sadly disbanded some years ago. Tragically at a time when
we were making real headway in advancing our understanding of the linguistic
forces that lay behind the work with our clients.

Sadly the prominence of this work
has been lost in the last 20 years and as a result direct therapy is largely
been swept into insignificance. Little and none of it is offered within the NHS
and I’d say that there are very few of us who practice it. In fact in some
quarters it is falsely derided as ineffective.

I really struggle to understand
how we lost our way as a profession in this arena of our work. Although I think
it happened at least in part, when in 1990’s we threw our lot in with the materialistic
scientific model and with that our complete capitulation to the idea that statistical
methodologies are the purest form of research.

In our attempt to gain
credibility and ‘be in with’ the hard hitters we aped the practices of our
medical and scientific colleagues and kicked into touch anything that represented
the human aspects of our work. In doing so we sealed the door closed on the
very essence of our intervention, ‘the therapeutic relationship’. Many of us
were uneasy with this abandonment of this crucial aspect of our work because we
knew this was the heartbeat of the therapeutic transformation. But the tide was
turning, and as a young profession we had not had time to develop a
sufficiently robust narrative through which we could fight our corner. The
weight of opposition was too great and many of us felt pushed into silence and those
of us who wanted to persist with working within the remit of the ‘therapeutic
alliance’ felt they had to do so quietly and without drawing attention to
themselves.

Sadly the sense of hopelessness
in the face of the devastation caused by neurological damage can leave people
believing that recovery of their linguistic functioning is impossible. Nothing
could however be further from the truth. Therapy works and people can making amazing
recoveries despite their initial prognosis but it takes a lot of time, great
skill and of course money. Institutionalised dogmatism and financial
imperatives are I believe the main driving forces for keeping the lid on a
therapeutic revisionism, despite evidence of the success of the work and the
increasing costs of supporting people who remain long term disabled.

There’s none as blind as them
that don’t see

I believe we must return our focus towards the efficacy of direct therapy.
In doing so we can identify the elements that contribute to successful outcomes,
including the impact of the therapeutic relationship. Given the exciting and
burgeoning evidence as to the brains plasticity never has there been a better
time for us to achieve fresh prospectives that would shine a more revealing light
on the underlying reasons for the successes many of us experience with our
clients. And with this greater understanding, our interventions could be
refined, to the point where we could reasonably expect to see a speeding up of
what is at present a lengthy process.

This would however require those in the field to develop new and
creative methods and protocols to explore and advance these ideas. And it would
also need those in this field to be brave enough to stand their ground when
speaking up for such new and possibly out there ideas.

Unfortunately fundamentalism is not restricted to aspects of Middle Eastern
politics, it is alive and kicking within the very fabric of our scientific
community. Consequently those of us who advance the notion of an alternative thesis,
often struggle to be heard. In the worst case scenarios we face the ever
growing threat of being restricted in our work practices and ‘the fear’ of
being struck off, where it is deemed these practices and methodologies fall
outside those sanctioned by the proponents of Evidenced Based Practice.

Despite the sometimes aggressive and unreasonable nature of the
opposition we potentially encounter, I believe that those of us in the field
ultimately have little to fear. As long as our rationale and debate is founded
within our clinical experiences and we are able to articulate the outcomes as a
result, in my experience the opposition melts in the light of robust evidence,
no matter how it is presented.

It is worth remembering that the success of the status quo is hugely
dependant on our compliance and more importantly our fear, but as long as we
remain loyal to our clients and to the integrity of our work, we will
ultimately find that all we are up against is ‘just another person’ with a
different point of view.

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About Me

I have worked in Independent Practice since 1998 and I love what I do with a passion. I take a no nonsense approach to my work and I have no fear of challenging conventional view points and thinking. Complacency of thinking is the enemy of good therapy.